- The upcoming open enrollment period is slated to feature something new: The debut of “simple choice plans” as an option to help consumers make "apples-to-apples cost-sharing comparisons" between plans so they can more easily identify the one with the best features for their needs.
- The rollout of this feature will depend on a few factors, including which regions will still have sufficient insurer participation to support choices in the first place; a recent Kaiser Family Foundation analysis predicted the number of counties with only one participating insurer will rise to 974, or 31%, of all counties in 2017, compared to 225, or 7% of counties, in 2016.
- Another major factor will be how many insurers choose to participate in offering simple choice plans, given that there is no requirement to do so on HealthCare.gov or most of the state-based marketplaces, Kaiser Health News reported.
Aside from the matter of where simple choice plans will be available is the question of whether they will actually help simplify consumers' shopping experience or not, given that there will also still be non-standardized plans available. Consumers will have to be able to follow what CMS promised would be "clear visual cues" to indicate which plans are easy to compare vs. the non-standard ones would need to be examined more deeply for differences.
If consumers still need to identify and compare between standardized and non-standardized plans, it's unclear whether shopping will be any quicker or easier than before.
“It’s really important to get the consumer shopping experience right, otherwise you might as well not bother," Sabrina Corlette of Georgetown University’s Center on Health Insurance Reforms told KHN. Corlette recently co-authored a study of states' efforts to provide standardized plans titled, "Missed Opportunities: State-Based Marketplaces Fail to Meet Stated Policy Goals of Standardized Benefit Designs."
Corlette's paper examined state-based marketplaces that required participating insurers to offer standardized plans in Connecticut, Massachusetts, New York, and Oregon and concluded that, "by allowing insurers to offer nonstandardized options in addition to standardized options and failing to use web-based decision support tools to differentiate between plan options, consumers in these SBMs have limited ability to conduct the plan-to-plan comparisons as originally envisioned by policymakers."
That is a fate that may or may not await any marketplaces that offer the new simple choice plans, which are slated to offer standardized deductibles, annual out-of-pocket spending limits, and co-payments for numerous medical services.
The upside to allowing insurers to continue to offer non-standardized plans as well, according to CMS' April announcement, is that it will "not stifle innovation so health plans can continue to offer all kinds of benefit options that will also be easy for consumers to find."